The inspection took place on 31 August and 5 September 2017 and was announced, to ensure staff we needed to speak with were available. Home Instead Senior Care Central Hampshire is a domiciliary care service which provides support to people in their own homes. Currently 46 people with diverse care needs, receive the regulated activity of personal care, although additional people received non-regulated activities, such as, light housekeeping and companionship.

The service had two registered managers. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives told us they felt safe in the care of staff, who had undertaken relevant training to enable them to identify signs of potential abuse. Staff had access to relevant policies and procedures to enable them to protect people.

There was a positive attitude to risk taking and the registered managers worked with people’s families and professionals to manage potential risks to people as safely as possible, in order that they could remain at home. People felt risks to them were well managed. Risks to people were documented, safely managed and understood by staff.

Staff said the service was “Well staffed.” People and their relatives told us they received their care calls at the time they wished, from regular staff, who had been introduced to them and who stayed for the required duration. People were kept safe as the provider had completed the required pre-employment checks to ensure staff’s suitability for their role.

Staff had completed medicines training and had their competency assessed. Staff did not always consistently follow the provider’s medicines policy or safe practice when they identified omissions in the recording of medicines administration, nor had they always informed the person’s GP following medicines incidents. The provider took swift action to ensure peoples’ safety when these matters were brought to their attention and made immediate arrangements for staff to be re-trained. It will take time for the provider to be able to demonstrate that the changes have become embedded in staff practice and that staff have consistently followed safe practice.

People felt staff were well trained and skilled. Staff underwent a thorough and comprehensive induction to prepare them for their role. They were supported and monitored by more experienced staff throughout their induction. Staff then received individualised training to enable them to develop their skills and knowledge in relation to the people they personally provided care for.

People and their relatives reported staff sought consent for people’s care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was clear guidance for staff with regards to whether people required assistance in preparing their meals and their food and drink preferences. People told us staff supported them with their eating and drinking where required, this ensured they received enough for their needs. Staff understood who was at risk of not eating or drinking properly and told us how these risks were managed effectively.

People told us they received any support they required to ensure their health needs were met. Staff informed us and records confirmed they had liaised with a range of healthcare professionals to promote people’s well- being.

People we spoke with, relatives and professionals all told us how caring, kind and compassionate staff were and how interested they were in people’s welfare. They all felt staff ‘went the extra mile’ when providing their care and support. Staff were